Obesity as an Independent Risk Factor for Infectious Morbidity in Patients Who Undergo Cesarean Delivery

Myles, Thomas D.; Gooch, Jason; Santolaya, Joaquín

doi:10.1097/00006250-200211000-00024

Cited by 78 publications

(106 citation statements)

References 18 publications

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“…All analysis was carried out using the statistical software SPSS version 16 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition. Both obesity and malnutrition have been associated with increased risk of SSI.…”

Section: Methodsmentioning

confidence: 57%

“…Both obesity and malnutrition have been associated with increased risk of SSI. 7,8 The association of obesity with SSI could be due to relative avascularity of adipose tissue and hence poor healing, difficulty in handling of tissues and hence more chance of micro-trauma and also failure in obliteration of dead spaces. Likewise malnutrition can lead to SSI due to poor healing of tissues and decreased immunity.…”

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confidence: 99%

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Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Chhetry¹,

Subedi

Banerjee

2017

J Coll Med Sci-Nepal

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Background & Objectives: Post cesarean surgical site infection (SSI) is one of the commonly encountered complications which considerably increase the burden to health care. It is caused due to the interplay of various patient related, procedure related and iatrogenic factors. This study aims at identifying common risk factors for post cesarean SSI at our centre. Materials & Methods: This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included and their risk factors were studied. Results: Emergency procedures (82.97%) were more likely to develop SSI as compared to elective cesarean (17%). Among the patient related risk factors most of them were nulliparous (48.9%), term gestation (42.6%), malnourished (53.1%) and had history of prolonged leaking (44.68%) The mean age was 24.04±4.6years.Most of the patients who developed SSI were operated for repeat cesarean and fetal indications. Most patients who had SSI had at three to five per vaginal examinations (2.72±2). 66% of patient who had SSI had duration of surgery more than one hour. 68% of the surgeries which developed SSI were done by residents as compared to 32% of those done by consultants Conclusion: The commonly associated risk factors linked with post cesarean SSI are maternal age, emergency procedures, prolonged membrane rupture, multiple vaginal examinations, malnutrition and the experience of surgeon. 3,4,6 One of the patient related factors is young maternal age as most of the infections (92%) occurred in women less than thirty years of age, this is in accordance with other studies. 7,8 Hypertensive disorders in pregnancy which is linked with chronic alteration in peripheral blood supply have been found to a risk factor for SSI.9, 10 In this study 27.7% of patients with SSI suffered from this condition. Both obesity and malnutrition have been associated with increased risk of SSI. 7,8 The association of obesity with SSI could be due to relative avascularity of adipose tissue and hence poor healing, difficulty in handling of tissues and hence more chance of micro-trauma and also failure in obliteration of dead spaces. Likewise malnutrition can lead to SSI due to poor healing of tissues and decreased immunity. In our study population malnutrition was a more common risk factor (53.1%) as compared to obesity (14.9%) and it is a reflection of the general population characteristic of our part of the world where most childbearing women are anemic and malnourished. Prolonged rupture of membrane (>8hrs) are established risk factors of SSI. 3,6,11 Even in the present study they were found to be significantly associated with SSI with prolonged PROM in 44.5% of patients and most patients with more than three per vaginal examinations. Loss of protective cervical mucus plug and barrier effect of fetal membranes and amniotic fluid after rupture of membranes are thought to be the culprits. The more the vaginal examinations the m...

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Section: Methodsmentioning

confidence: 57%

mentioning

confidence: 99%

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Chhetry¹,

Subedi

Banerjee

2017

J Coll Med Sci-Nepal

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“…1 The rates of SSI after cesarean section reported in the literature range from 3% to 15%, depending on the surveillance methods used to identify infections, the patient population, and the use of antibiotic prophylaxis. [2][3][4][5][6][7][8][9][10][11] The pooled mean rate of SSI after cesarean section for US hospitals participating in the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System is 3.15%. 12 Expanding our knowledge of the risk factors associated with SSI is essential to developing targeted prevention strategies to reduce the risk of SSI.…”

Section: Infect Control Hosp Epidemiol 2008; 29:477-484mentioning

confidence: 99%

Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section

Olsen

Butler

Willers

et al. 2008

Infect. Control Hosp. Epidemiol.

270

176

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“…A few previous studies have found that abdominal surgery for a gynecologic benign condition (other than POP) is associated with a greater incidence of wound infection in obese women compared to non-obese women. 6,16,17 In contrast, vaginal surgery for a hysterectomy or POP in obese women is associated with less morbidity than abdominal surgery in terms of blood transfusions or urinary retention. 18 In the literature, there are some discrepancies concerning the impact of BMI on RALSCP outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparison of functional outcomes after robot-assisted laparoscopic sacrocolpopexy in women with a BMI below and above 30

Thubert

Dabi

Joubert

et al. 2017

UIJ

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The aim of this study was to assess the impact of body-mass index on robot-assisted laparoscopic sacrocolpopexy (RALSCP). A retrospective study was conducted on women who underwent a RALSCP. Data were collected prospectively from 17 obese and 78 non-obese patients treated between January 2008 and January 2013. Obesity was defined as a body-mass index (BMI) of ≥30 kg/m 2 . Relationships with outcome analysed using MannWhitney U-test and Fisher's exact test. The operating time was the same in both groups: 220 vs 200 min in the obese and non-obese groups, respectively (P=0.232). The median follow-up was 12 months in both non-obese and obese patients. Overall anatomic repair rate was 94.1% and 97.4% for obese and non-obese patients, respectively (P=0.95). The overall reoperation rate (including surgery for de novo urinary-stress incontinence) was 5.9% for obese vs 11.5% for non-obese patients (P=0.8). These findings suggest that RALSCP is a viable option for obese women. The complication rates and outcomes for obese women were similar to those for non-obese women.

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Obesity as an Independent Risk Factor for Infectious Morbidity in Patients Who Undergo Cesarean Delivery

Cited by 78 publications

References 18 publications

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Risk factors for post caesarean surgical site infection at a tertiary care center in Eastern Nepal

Risk Factors for Surgical Site Infection After Low Transverse Cesarean Section

Comparison of functional outcomes after robot-assisted laparoscopic sacrocolpopexy in women with a BMI below and above 30

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